The regulation of NHS managers must be supported by professional development and ‘just and restorative cultures’, according to NHS leaders.
In its response to the Department of Health and Social Care (DHSC) consultation on plans to regulate NHS managers, including ICB board members, NHS Employers and NHS Confederation said there ‘should not be fear of accountability’.
The 12-week consultation was launched in November 2024 and closed on 18 February 2025. It included options for regulation, such as a voluntary accreditation register, statutory barring mechanisms and full statutory registration.
The response said the regulation must be clear in its purpose, aims and objectives, and proportionate in its approach. It also called for principles of fairness, equality and trust within the regulation.
It said: ‘In implementing any new regulatory process, our members seek assurance that there will be consideration as to how we can best support senior NHS leaders with professional development and support.
‘There is a need to ensure that people can succeed in their roles and that we create the right environment for them to work in. We believe that there is a great deal of positive work that can be built on to deliver the continued professional development required to meet the requirements of a new regulatory process.’
The response, which was informed by the views of CEOs, chairs, chief people officers and senior board workforce leaders across the NHS, also questioned who should be considered under a new regulatory framework. It suggested this should apply to all NHS organisations, including arm’s length bodies and ICBs. But that some members said it should focus on those holding board level roles and that middle managers in the NHS were ‘already overburdened’.
It added that clinical managers should be required to meet the same standards as non-clinical managers to improve parity of accountability.
It said: ‘Some members of NHS boards are already subject to professional regulation through bodies such as the General Medical Council (GMC), Nursing and Midwifery Council (NMC), Health and Care Professions Council (HCPC) and some accountancy bodies. Any new regulatory framework would need to take account of any potential dual regulation and seek to avoid duplication of effort and action.’
It comes as NHS England has announced it will conduct a ‘significant’ review of all postgraduate medical training, including GP programmes.
Earlier this month, it was revealed that patients are put off seeking healthcare due to ‘dysfunctional’ NHS admin that traps them in a ‘doom loop’.
Key points from NHS Employers and NHS Confederation:
- NHS leaders agree there should not be fear of accountability.
- Any new regulatory framework needs to be clear in its purpose, aims and objectives, as well as explicit in the problem it is seeking to resolve.
- Regulation must be supported with robust standards for practice, professional development, clear and simple processes, just and restorative cultures, and underpinned by principles of fairness, equality and trust.
- Regulation must be proportionate in its approach and positioned as an opportunity to raise the standards of the profession.
- NHS leaders welcome the introduction of a new professional duty of candour.
